Provider Demographics
NPI:1013605286
Name:KIRCH, JONATHAN BRETT
Entity type:Individual
Prefix:
First Name:JONATHAN
Middle Name:BRETT
Last Name:KIRCH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:97 BALDWIN CT
Mailing Address - Street 2:
Mailing Address - City:HOWARD
Mailing Address - State:OH
Mailing Address - Zip Code:43028-9582
Mailing Address - Country:US
Mailing Address - Phone:740-438-2319
Mailing Address - Fax:
Practice Address - Street 1:97 BALDWIN CT
Practice Address - Street 2:
Practice Address - City:HOWARD
Practice Address - State:OH
Practice Address - Zip Code:43028-9582
Practice Address - Country:US
Practice Address - Phone:740-438-2319
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-26
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251X00000XAgenciesSupports Brokerage